Survival of patients with prostate cancer and normal PSA levels treated by radical prostatectomy

RESUMO

INTRODUCTION: The unpredictability of prostate cancer has become a daily challenge for the urologist, with different strategies being required to manage these cases. In this study, we report on the perspectives for curing prostate cancer in males undergoing radical prostatectomy with Gleason score of 2-6 on prostate biopsy in relation to pre-operative PSA levels. MATERIALS AND METHODS: From 1991 - 2000, we selected 440 individuals whose pathological diagnosis revealed a Gleason score of 2-6 upon prostate biopsy and who subsequently underwent retro-pubic radical prostatectomy due to localized prostate cancer. The clinical stage identified in the group under study was T1c 206 (46.8 percent); T2a 122 (27.7 percent); T2b 93 (21.1 percent); T2c 17 (3.9 percent); T3a 2 (0.5 percent). Following surgery, we constructed a biochemical recurrence-free survival curve according to pre-operative PSA levels between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL, with a median follow-up of 5 years. RESULTS: Following radical prostatectomy, the pathological stage was confirmed as pT2a 137 (31.1 percent); T2b 118 (26.8 percent); T2c 85 (19.3 percent); T3a 67 (15.2 percent); T3b 6 (1.4 percent); T3c 22 (5 percent). The biochemical recurrence-free survival, according to PSA values between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL, was 86.6 percent, 62.7 percent, 39.8 percent and 24.8 percent respectively. CONCLUSION: Better chances for curing low-grade prostate cancer occur in individuals with normal PSA for whom a biopsy is not usually recommended.